The crosstalk network of non-coding RNAs: Emerging opportunities for the clinical application of osteoporosis

Current methods for testing bone density lack the capability to detect patients with early bone loss, and existing osteoporosis therapies have limitations in their efficacy and safety. Therefore, the development of more precise and convenient diagnostic technologies and novel treatments is of paramount importance. Extracellular vesicle (EV)-mediated non-coding RNA (ncRNA) interaction networks enable both the detection of early bone loss and targeted therapy for enhanced treatment outcomes. In this review, we highlight the utility of EVs for carrying various ncRNAs (e.g., miRNAs, lncRNAs, and circRNAs) and thereby forming a complex regulatory network amongst bone-related cells such as osteoblasts and osteoclasts. The mechanisms through which EVs regulate bone cells and their potential for clinical translation are described in detail. Although the EV-mediated ncRNA network holds great promise for the precise diagnosis and targeted treatment of osteoporosis, rigorous large-scale studies are still required to address challenges related to its specificity and clinical application.